铥激光前列腺切除术治疗良性前列腺增生(附32例报告)

Thulium laser resection of prostate in the treatment of benign prostate hyperplasia:A report of 32 cases

目的 探讨铥激光前列腺切除术（thulium laser resection of prostate,TmLRP）治疗良性前列腺增生症（benign prostate hyperplasia,BPH）的手术方法并评估其安全性和有效性. 方法 应用50 W波长2 μm连续波铥激光对32例BPH行TmLRP.前列腺体积（48.2±21.5）ml,术前IPSS评分（24.4±6.7）分,最大尿流率（7.6±3.4）ml/s. 结果 手术时间（52.8±20.2）min,术中无明显出血,无手术并发症,术前术后血K^＋、Na^＋、Cl-浓度及血红蛋白差异无显著性（P＞0.05）.术后导尿管留置时间平均2.5 d（2～4）d.随访时间5～24个月,平均17个月.术后1个月IPSS评分（6.7±2.4）分,最大尿流率（16.3±6.1）ml/s,与术前（24.4±6.7）分、（7.6±3.4）ml/s相比明显改善（t=8.975、7.325,P＜0.05）. 结论 铥激光前列腺切除术是一项简单有效、微创、并发症少的理想手术方法,其效果同TURP术相当,且安全性高.

Objective To evaluate the safety and efficacy of thulium laser resection of prostate （TmLRP） in the treatment of benign prostate hyperplasia （ BPH）. Methods Thirty-two patients with BPH were treated with TmLRP using 50 W and 2 μm thulium laser. Before the operation, the prostate volume was 48.2 ± 21.5 ml, the international prostate symptom score （IPSS） was 24.4 ±6.7, and the maximum urinary flow, 7.6 ± 3.4 ml/s. Results The operating time was 52. 8 ± 20. 2 min. No obvious hemorrhage was seen during the operation. No surgical complication was observed. There were no significant differences in values of serum sodium, potassium, chlorine, and hemoglobin before and after operation （ P 〉 0.05 ）. The urethral catheter was indwelled for a mean of 2. 5 days （2 -4 days）. Follow-up examinations were conducted for 5 -24 months （mean, 17 months）. At the first postoperative month, the IPSS and maximum urinary flow were 6.7 ± 2.4 and 16.3 ±6. 1 ml/s, respectively, both of which were significantly improved as compared with preoperative values （t = 8. 975 and 7. 325, P 〈 0.05）. Conclusions TmLRP is a safe and efficient procedure for the treatment of BPH.